What is the risk of a complication during Laser Eye Surgery?

With over 50 million procedures performed world-wide to date and a 25 year track record of improvements, Laser Eye Surgery is one of the safest options for vision correction. Just as contact lenses are not risk free, neither is laser eye surgery. However, in expert hands, the safety of laser eye surgery is similar to that of daily contact lens wear, and even safer than extended wear contact lenses.

It is not possible to fully summarise this information here, and all our patients undergo an extremely detailed process to gain informed consent for surgery. Patients at the London Vision Clinic will spend at least two hours, and often longer, for full assessment and discussion about risks with our surgeons and optometrists before proceeding to vision correction surgery. If a patient wants more time, this is easily arranged. This investment of time on our part for each patient, we are confident, is second to none.

The fact is that an expert laser eye surgeon will have the knowledge to manage complications properly and will most probably be able to correct complications that may occur. One may think of this in terms of the difference between a GP or a midwife delivering a baby versus a specialist obstetrician.

When we define what constitutes a complication, one way is to think in terms of damage to the vision. Damage to the vision would mean some blurring, doubling, distortion or something not right with the vision that could no longer be corrected by spectacles to the level before surgery. Overall, 98% of people with a refractive error have blurring, doubling or distortion without glasses, but can see down to the 20/20 line with glasses. Scientifically we define a ‘small amount of damage’ to mean that the eye has lost two lines on the vision chart, even with spectacles, compared to the vision before surgery. For an eye that could see 20/20 with glasses before surgery, the vision with glasses after surgery would be 20/30, which is still within the legal driving standard.

In the hands of an expertly trained surgeon, operating with the optimal technology for diagnostics and treatment, the chance of a small amount of damage to the vision is approximately 1 in 1,000 for most cases.

The chances are extremely low that an expert laser eye surgeon would face a complication that he or she would not be able to either fully correct or almost fully correct. This is because an expert surgeon can manage most complications, as long as they have advanced diagnostic equipment such as the Artemis Insight VHF digital ultrasound scanner and high resolution OCT (optical coherence tomography), and the repair tool technology: phototherapeutic keratectomy (PTK) technology and topography-guided laser technology. At the London Vision Clinic, not only do we have every single diagnostic and therapeutic option available to us in the unlikely event that we would need it, Professor Reinstein and his team have been responsible for developing many of these tools for the benefit of experts around the world.

We keep meticulous records of all our statistics and have follow-up rates that are literally second to none. Over the last 15 years, the London Vision Clinic has published more scientific papers in the field of refractive surgery than any other provider, and we are leading developers of complication repair techniques and technology. We manage to see 90% of all patients we treat at 1 year and many continuously thereafter for routine follow-up. Most providers discharge patients once they are seeing well after 1 month or 3 months, and are therefore unable to provide final statistics for 1 year outcomes. Our own audited track record for patients in whom we were unable to recover vision to within 2 lines of the original best spectacle corrected vision shows that the chance of this happening is 0.02% (5 eyes out of 25,500 procedures) where we treated short-sightedness (myopia) up to ‑14.00 D, long-sightedness (hyperopia) up to +7.00 D, and astigmatism up to 6.00 D, as well as eyes with the more unusual form of mixed astigmatism.

For more information on the risks of laser eye surgery and their management, do contact us. We are happy to talk about this openly and transparently.